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DOI: 10.1055/s-2002-32320
Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662
The Efficacy of a Novel Tongue-Stabilizing Device on Polysomnographic Variables in Sleep-Disordered Breathing: A Pilot Study
Publication History
Publication Date:
19 June 2002 (online)
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ABSTRACT
The polysomnographic efficacy of a novel tongue-stabilizing device (TSD) in the treatment of snoring and sleep-disordered breathing (SDB) was evaluated in this pilot study. Six current users of the TSD with SDB underwent polysomnography with and without the TSD in situ in a randomized crossover design. The TSD significantly lowered the frequency of snores per hour slept (61- to 70-dB range) (no TSD: mean = 41/h slept ± 52 SD; TSD: 8/h slept ± 16 SD; P = 0.046) but did not alter snoring in the other decibel ranges (all Ps > 0.1). Trends were found for reductions in the frequency of apneas plus hypopneas (no TSD: 26/h slept ± 17/h slept; TSD: 15/h slept ± 13; P = 0.06) and oxygen desaturations of 4% or more (no TSD: 10/h slept ± 10; TSD: 5/h slept ± 5; P = 0.09). Significant improvements in microarousal frequency with the TSD were found (no TSD: 34/h slept ± 16; TSD: 22/h slept ± 14; P = 0.004). Significant reductions in percentage of Stage 1 sleep with the TSD were also demonstrated (no TSD: 10 ± 3%; TSD: 8 ± 2%; P = 0.03). The results of this small pilot study indicate that the TSD may be effective in reducing snoring severity and microarousals, with favorable trends for reducing SDB severity in selected individuals. Additional larger prospective studies are required to identify suitable candidates for TSD use in the treatment of snoring and SDB.
KEYWORDS
Oral appliances - tongue retainers - sleep-disordered breathing - snoring
REFERENCES
- 1 Lugaresi E, Mondini S, Zucconi M, Montagna P, Cirignotta F. Staging of heavy snorers' disease: a proposal. Bull Eur Physiopathol Respir . 1983; 19 590-594
- 2 Sullivan C E, Berthon-Jones M, Issa F G, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet . 1981; 1 862-865
- 3 McArdle N, Devereux G, Heidarnejad H. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med . 1999; 159 1108-1114
- 4 Lowe A A. Dental appliances for the treatment of snoring and obstructive sleep apnea. In: Kryger MA, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine 2nd ed. Philadelphia, PA: WB Saunders 1994: 722-735
- 5 Schmidt-Nowara W, Lowe A A, Wiegand L. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep . 1995; 18 501-510
- 6 Ferguson K A, Ono T, Lowe A A, Keenan S P, Fleetham J A. A randomized crossover study of an oral appliance vs. nasal continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea. Chest . 1996; 109 1269-1275
- 7 Cartwright R D, Samelson C F. The effects of a nonsurgical treatment for obstructive sleep apnea. The tongue-retaining device. JAMA . 1982; 248 705-709
- 8 Cartwright R, Ristanovic R, Diaz F, Caldarelli D, Alder G. A comparative study of treatments for positional sleep apnea. Sleep . 1991; 14 546-552
- 9 Ferguson K A, Love L L, Ryan C F. Effect of mandibular and tongue protrusion on upper airway size during wakefulness. Am J Respir Crit Care Med . 1997; 155 1748-1754
- 10 Ono T, Lowe A A, Ferguson K A, Pae E K, Fleetham J A. The effect of the tongue retaining device on awake genioglossus muscle activity in patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop . 1996; 110 28-35
- 11 Douglas N J, Thomas S, Jan M A. Clinical value of polysomnography. Lancet . 1992; 339 347-350
- 12 Rechtschaffen A, Kales A. A Manual of Standardised Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects. Los Angeles: University of California, Los Angeles 1968
- 13 Gould G A, Whyte K F, Rhind G B. The sleep hypopnea syndrome. Am Rev Respir Dis . 1988; 137 895-898
- 14 Atlas Task Force of the American Sleep Disorders Association. EEG arousals: scoring rules and examples. A preliminary report. Sleep . 1992; 15 174-184
- 15 Hills M, Armitage P. The two-paired crossover trial. Br J Pharmacol . 1979; 8 7-20
- 16 Bryman A, Cramer D. Quantitative Data Analysis with SPSS for Windows. London: Routledge 1997
- 17 Clark G A, Cartwright R D. A survey of treatment efficacy of patients fitted with tongue retaining device. Sleep Res . 1995; 24 213
- 18 Stradling J R, Negus T W, Smith D. Mandibular advancement devices for the control of snoring. Eur Respir J . 1998; 11 447-450
- 19 Cartwright R D. Predicting response to the tongue retaining device for sleep apnea syndrome. Arch Otolaryngol . 1985; 111 385-388